Advanced Prostate Cancer

Extreme Pain In Lower Back

Hi everzone.

Paul woke up during the night with extreme pain in his lower back, near the right hip. The pain is constant and makes it hard for him to move. It is sensitive to the touch and he told me not to touch it because it hurts.

Does this sound to zou like cancer/related pain or more like a muscular pain?

What speaks against cancer pain is that the scan didn't show any changes to before. But we don't know.

Mel.

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Is there a rash? Could it be shingles?

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No, there is no rash.

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Kidney stones? History of bone matisis?

If it continues and is unbearable I would go to the ER.

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The pain is too low down for kidney stones. But bone mets? Yes, he has many of them and all are in the lower back region.

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I don’t remember whether Paul has any bone mets. I hope not, but if so, this sounds like some pain I had last year that ended up being from my spinal mets. Spinal radiation has helped. I hope it’s something simpler, but if they rule other sources out, you may want to seek an MRI. (I had two—thoracic and lumbar.) Best to you.

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Well, the last bone scan showed no difference to the previous one so no growth in bone mets. We will have to go to hospital on Monday anyway to get pre-chemo bloods done so will talk to the doctor then if pain is still there.

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Hi Melanie

The cancer pain is normally related to a Tumor is near a nerve and pushing against it. This type of pain, feels like the source is on fire, “burning pain”. The tumor growth may cause nerve damage or the nerve to be broken. The effect is losing control for moving the effected muscle, such as part of the leg is paralyzed, etc. The tumor can be killed, by releasing chemical into it, via a shot under a CT scan, "ablation". My recommendation is to perform ablation to kill the tumor.

Bruce

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Hi all, and thanks for your responses.

Paul has been lying on a heating pad almost all day and the pain is better when he does. So we think now that it may be muscular pain after all. But we will check with the doctor anyway. The pain is not burning, but it is like a strong pressure, and Paul says it is very sore to the touch. That is not necessarily normal for cancer pain, is it?

Mel.

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Really sorry for the enemy ( pain) ...

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my husband used a heating pad day and night for his bone mets pain...and got relief. do not assume it is muscular. they radiated that area and it went away, for the most part. now, as a woman, i took one wrong step one morning that made my hip reveal that it was rotten. i had a hip resurfacing and all the pain went away. i too sought relief from a heating pad and it would subside while i awaited surgery. i would call my doc and have him order a CT and bone scan BEFORE i went to see him, just to save a trip.

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I do not have personal or clinical experience, but if your husband is having a new terrible pain and you know that he has bone metastasis in the vertebral bodies, I believe he should be seen in the Emergency to determine if there is a compression of nerves. In general the sooner that these conditions are treated the better the chance of control of the pain and the possibility of recover the normal function. Losing time may led to irreparable injury.

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Is there loss of range of motion, what we call muscle guarding. If so. It is muscle strain.

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All this not knowing could drive one nuts. Hang tuff!! I’m praying it’s nuttin.

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Hi Mel,

It's good that Paul had a recent bone scan, but what about a CT scan? I always get both the same day. I get pain in that area, but when I'm active, not asleep. Mine responds to ice packs & physical therapy, but I can count on it to recur. But it's muscular. Does taking a walk relieve Paul, cause pain, or do nothing? Getting a PT referral could help a lot, so he'd know some exercises that are appropriate for relieving the pain. Good luck!

Neal

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Hi Mel!

A PT referral can be done by most any doctor. I had one about 10 years ago (4 years before PCa diagnosis) and it helped me quite a bit. A couple of months of back strengthening exercises made me feel much better. An x-ray had revealed problems in the L4-L5 area. So if no bone mets causing the problem, PT is worth looking into. Good luck!

Marshall

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Sounds like some boney- neuropathic pain. When was his last scan? I would speak to Oncologist. We recently saw pain specialist and he is on a new regimen. Tough pain to manage. Hoping for the best, sending up prayers and encouragement for you both. 💚🙏🏽💚

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Hoping it is muscular related and he feels better very soon! Jim

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You really need to talk to the doctors and figure it out. Probably some additinal scans. The bone scan is not very sensitive to details - so as someone else said - a CT or MRI (I can never keep straight which one is better for what). And see a radiation oncologist -- even if it is just to review all the scans with the expert. Our RadOnc is our favorite doctor (well, within this weird world we now live in).

Not to scare because it could be anything -- but my husband got his diagnosis of prostate cancer because of severe hip pain (similar to what you describe) which turned out to be a hairline fracture in his pelvis, from bone mets (when we didn't even know he had cancer at age 51), and this led to bleeding into the joint space which is extremely painful, adds to pressure, etc. There is also possibility of tumor pressing on a nerve. Spot radiation can be very helpful for pain. In fact, for bone mets, as I understand it, the main reason for radiation is for pain reduction.

Also - get your husband some pain medication. Of course you don't want to numb the pain and then do a bunch of stuff that might worsen the situation but at least numb the pain and be able to walk around the house and have some pain-free/limited moments. I also believe that pain begets tension begets more pain. If you can nip pain in the bud (or close) then your body can relax and heal. I had a chronic back condition for a while and only took painkillers when it was extreme, and then my PT said, take the pain meds regularly for a little while, and all of a sudden I realized how different the world was when I wasn't in pain all the time! (and that was moderate pain) Yes, yes, be careful with opiods, but despite all their issues, they do work and have a function when used properly.

Truly hoping it is one of the more minor culprits! Best wishes - Brenda

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With bone Mets, do doctors still use xgeva? When my psa elevated after surgery then radiation, I started shots every 3 months of ADT treatment (Elligard) and Xgeva, this was June 2014. Bone mets seemed to have stabilized but psa began to rise after 3 yrs, so now am using Xtandi, but have continued my 3 month shots. Maybe the Xgeva is helping with bone pain so far. Prayers for all.

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Hi everyone, and thank you for your responses.

The doctor believes it is a spot that has become active during Paul's 5 week break from the Chemo. And now that Paul is back on the Chemo again that pain has eased. It is almost gone. But the doctor wants to do an X-ray anyway to be sure.

Mel.

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